Phosphatidylinositol-3-kinase p110δ serves as a central integration point for signaling from cell surface receptors known to promote malignant B-cell proliferation and survival. This provides a rationale for the development of small molecule inhibitors that selectively target p110δ as a treatment approach for patients with B-cell malignancies. We thus identified 5-fluoro-3-phenyl-2-[(S)-1-(9H-purin-6-ylamino)-propyl]-3H-quinazolin-4-one (CAL-101), a highly selective and potent p110δ small molecule inhibitor (half-maximal effective concentration [EC(50)] = 8nM). Using tumor cell lines and primary patient samples representing multiple B-cell malignancies, we have demonstrated that constitutive phosphatidylinositol-3-kinase pathway activation is p110δ-dependent. CAL-101 blocked constitutive phosphatidylinositol-3-kinase signaling, resulting in decreased phosphorylation of Akt and other downstream effectors, an increase in poly(ADP-ribose) polymerase and caspase cleavage and an induction of apoptosis. These effects have been observed across a broad range of immature and mature B-cell malignancies, thereby providing a rationale for the ongoing clinical evaluation of CAL-101.

IntroductionChronic lymphocytic leukemia (CLL) is the most common type of adult leukemia in the United States, with approximately 15 000 new cases and approximately 4500 deaths per year. 1 CLL is characterized by a B1 monoclonal lymphocyte immunophenotype with expression of the surface antigens CD19, CD5, CD20, CD23, and dim surface immunoglobulin G. The cell of origin of CLL is uncertain, but a gene expression pattern most similar to a mature memory B cell has been hypothesized. 2 In addition, CLL cells display disrupted apoptosis that is caused by both primary tumor features and codependent stromal elements. 3 Although many patients are asymptomatic at diagnosis, CLL is a progressive disease that in most patients eventually will require treatment. Once they become symptomatic, patients have a relatively short overall survival, ranging from 18 months to 6 years, with a 22.5% 10-year survival expectation. 4 Common treatments for CLL include alkylating chemotherapeutic drugs (such as chlorambucil and cyclophosphamide), purine analogs (such as fludarabine), and rituximab (used in combination with fludarabine, fludarabine and cyclophosphamide, or pentostatin and cyclophosphamide). Newer studies with either single-agent bendamustine or alemtuzumab have been shown to have improved response and progression-free survival over alkylator-based therapy. However, no current treatment option results in curative therapy, and all patients eventually relapse. This provides strong justification for developing additional types of therapies for CLL. Of particular interest are therapies that target signal transduction pathways essential to CLL cell survival mechanisms that are known to be aberrantly activated.One such pathway is the phosphoinositide 3-kinase (PI3K) pathway. The PI3K pathway is acknowledged as a key component of cell survival in many cancers, including CLL. It is activated by receptors, or the small guanosine triphosphatase Ras, and is made up of various classes of PI3K isoforms. 5 There are 3 classes of PI3K isoforms; however, only the class I isoforms phosphorylate inositol lipids to form second messenger phosphoinositides. Specifically, class I PI3K enzymes convert PtdIns(3,4)P 2 into PtdIns(3,4,5)P 3 , in the cell membrane that recruit, via binding to the amino-terminal pleckstrin homology domain, downstream signaling proteins such as Tec kinases, phosphatidylinositol-dependent kinase, Akt, integrin-linked kinase, and Rac guanine exchange factor. Class I isoforms are made up of 2 subsets (IA and IB). Class IA encompasses p110␣, p110␤, and p110␦ (catalytic domains), bound by p85, p50, or p55 (regulatory domains). Class IB is made up solely of the p110␥ (catalytic domain) bound by the regulatory domain p101. The p110␣ and p110␤ isoforms are ubiquitously expressed, and knock-out mice for both are embryonic lethal. 6 It is thought that this widespread functionality of PI3K signaling is at An Inside Blood analysis of this article appears at the front of this issue.The publication costs of this article were defrayed ...

In lymphocytes, the phosphoinositide 3-kinase (PI3K) isoform p110␦ (PI3K␦) transmits signals from surface receptors, including the B-cell receptor (BCR). CAL-101, a selective inhibitor of PI3K␦, displays clinical activity in CLL, causing rapid lymph node shrinkage and a transient lymphocytosis. Inhibition of pro-survival pathways, the presumed mechanism of CAL-101, does not explain this characteristic pattern of activity. Therefore, we tested CAL-101 in assays that model CLLmicroenvironment interactions in vitro.We found that CAL-101 inhibits CLL cell chemotaxis toward CXCL12 and CXCL13 and migration beneath stromal cells (pseudoemperipolesis) . IntroductionChronic lymphocytic leukemia (CLL), the most common leukemia in Western countries, is characterized by the accumulation of CD5 ϩ /CD23 ϩ monoclonal B cells in the blood and tissue compartments (marrow and secondary lymphatic tissues). 1 CLL cells are resistant to cell death in vivo. However, they rapidly die from spontaneous apoptosis once removed from the patient unless they are cocultured with accessory stromal cells, such as marrow stromal cells (MSCs) 2 or monocyte-derived nurse-like cells (NLCs). 3 Cross-talk between CLL cells and these supporting cells in tissue microenvironments comprises a complex signaling network that may be critical for disease progression and drug resistance. Interference with this cross-talk may constitute a new therapeutic target. Several molecular pathways related to leukemia cell migration, B-cell receptor (BCR) signaling, and interactions between CLL cells and T cells have been identified over recent years (reviewed in Burger et al 4 ).The chemokines, CXCL12 and CXCL13, are constitutively secreted by MSCs and NLCs 5,6 and attract CLL cells via their respective cognate chemokine receptors, CXCR4, CXCR5, thereby regulating homing and retention of the leukemia cells in the tissue compartments. In addition, BCR signaling in the lymphatic tissue microenvironment promotes the clonal expansion of normal and malignant B cells. 1,7,8 CLL cells isolated from lymph nodes 8 or high-risk patients 9 display gene expression profiles that indicate BCR activation. In response to BCR activation and in NLC cocultures, CLL cells secrete the chemokines CCL3 and CCL4 (also called MIP-1␣ and ␤), 10 presumably for recruitment of accessory cells, such as regulatory T cells. 11,12 We proposed that the secretion of CCL3 and CCL4 by CLL cells correlates with the responsiveness of the BCR, based on higher secretion of CCL3/4 in ZAP-70 ϩ cases, 10 and a close correlation between CCL3 plasma levels and ZAP-70, IgHV mutational status, and prognosis. 13 Phosphoinositide 3Ј-kinases (PI3Ks) integrate and transmit signals from diverse surface molecules, such as the BCR, 14 chemokine receptors, and adhesion molecules, thereby regulating key cellular functions, including growth, survival, and migration. 15 The PI3Ks are divided into 3 classes; I, II, and III. The class I kinases contain 4 isoforms designated PI3K␣, ␤, ␥, and ␦. While the PI3K␣ and ␤ isoforms are ...

A detailed comparison in the developing rat central nervous system between the distribution of the NG2 proteoglycan and the α‐receptor for platelet‐derived growth factor (PDGF) shows that these two molecules are co‐expressed by glial progenitor cells of the O2A lineage and can serve as reliable markers for identification of O2A cells in vivo. Our mapping experiments indicate that NG2‐positive, PDGF α‐receptor positive O2A cells are abundant throughout the developing central nervous system in both white and gray matter. The earliest cells immunoreactive for either of the two markers are found adjacent to the central canal of the embryonic day 15 (E15) spinal cord. These cells express only PDGF α‐receptor and not NG2. By E17, process‐bearing cells expressing both NG2 and PDGF α‐receptor in a highly co‐localized fashion are found throughout the central nervous system. The first postnatal week marks the peak in the number of NG2 and PDGF α‐receptor immunoreactive cells, as well as the peak in the level of expression and the extent of co‐localization of the two molecules. After the first week, the level of expression of both NG2 and PDGF α‐receptor declines, although both molecules continue to be expressed in the adult brain. On O2A cells in the mature brain, NG2 and PDGF α‐receptor are not as well co‐localized at the subcellular level as they are on O2A cells in the younger brain. The functional consequences of co‐localization and subsequent dissociation of NG2 and PDGF α‐receptor on maturing O2A progenitors are investigated in the accompanying paper (Nishiyama et al.: J Neurosci Res 43:315–330, 1996). © 1996 Wiley‐Liss, Inc.

Platelet-derived growth factor (PDGF) has been directly implicated in developmental and physiological processes, as well as in human cancer, fibrotic diseases and arteriosclerosis. The PDGF family currently consists of at least three gene products, PDGF-A, PDGF-B and PDGF-C, which selectively signal through two PDGF receptors (PDGFRs) to regulate diverse cellular functions. After two decades of searching, PDGF-A and B were the only ligands identified for PDGFRs. Recently, however, database mining has resulted in the discovery of a third member of the PDGF family, PDGF-C, a functional analogue of PDGF-A that requires proteolytic activation. PDGF-A and PDGF-C selectively activate PDGFR-alpha, whereas PDGF-B activates both PDGFR-alpha and PDGFR-beta. Here we identify and characterize a new member of the PDGF family, PDGF D, which also requires proteolytic activation. Recombinant, purified PDGF-D induces DNA synthesis and growth in cells expressing PDGFRs. In cells expressing individual PDGFRs, PDGF-D binds to and activates PDGFR-beta but not PDGFR-alpha. However, in cells expressing both PDGFRs, PDGF-D activates both receptors. This indicates that PDGFR-alpha activation may result from PDGFR-alpha/beta heterodimerization.

Up to 30% of acute myelogenous leukemia (AML) patients harbor an activating internal tandem duplication (ITD) within the juxtamembrane domain of the FLT3 receptor, suggesting that it may be a target for kinase inhibitor therapy. For this purpose we have developed CT53518, a potent antagonist that inhibits FLT3, platelet-derived growth factor receptor (PDGFR), and c-Kit (IC(50) approximately 200 nM), while other tyrosine or serine/threonine kinases were not significantly inhibited. In Ba/F3 cells expressing different FLT3-ITD mutants, CT53518 inhibited IL-3-independent cell growth and FLT3-ITD autophosphorylation with an IC(50) of 10-100 nM. In human FLT3-ITD-positive AML cell lines, CT53518 induced apoptosis and inhibited FLT3-ITD phosphorylation, cellular proliferation, and signaling through the MAP kinase and PI3 kinase pathways. Therapeutic efficacy of CT53518 was demonstrated both in a nude mouse model and in a murine bone marrow transplant model of FLT3-ITD-induced disease.

Mutations constitutively activating FLT3 kinase are detected in ∼30% of acute myelogenous leukemia (AML) patients and affect downstream pathways such as extracellular signal–regulated kinase (ERK)1/2. We found that activation of FLT3 in human AML inhibits CCAAT/enhancer binding protein α (C/EBPα) function by ERK1/2-mediated phosphorylation, which may explain the differentiation block of leukemic blasts. In MV4;11 cells, pharmacological inhibition of either FLT3 or MEK1 leads to granulocytic differentiation. Differentiation of MV4;11 cells was also observed when C/EBPα mutated at serine 21 to alanine (S21A) was stably expressed. In contrast, there was no effect when serine 21 was mutated to aspartate (S21D), which mimics phosphorylation of C/EBPα. Thus, our results suggest that therapies targeting the MEK/ERK cascade or development of protein therapies based on transduction of constitutively active C/EBPα may prove effective in treatment of FLT3 mutant leukemias resistant to the FLT3 inhibitor therapies.

In this study, we demonstrate expression and examined the biologic sequelae of PI3K/p110␦ signaling in multiple myeloma ( IntroductionThe bone marrow (BM) microenvironment plays a crucial role in pathogenesis of multiple myeloma (MM) by promoting cell proliferation, survival, migration, and drug resistance. [1][2][3][4] The PI3K/AKT pathway mediates growth and drug resistance in MM cells and also plays a significant role in autophagy. 5,6 PI3K is activated via upstream tyrosine kinase-associated receptors for growth factors, cytokines, antigens, and costimulatory molecules. It in turn activates AKT, which mediates cell proliferation, cell cycle, apoptosis, and autophagy. 7 Class IA PI3K consists of 5 isoforms of regulatory subunits (p85␣, p50␣, p55␣, p85␤, and p55␥), which interact with class IA isoforms. Class IA PI3K is composed of p110␣, -␤, and -␦ isoforms. 8 Among the 8 distinct mammalian isoforms of PI3K, class I PI3Ks are responsible for Akt activation. Importantly, p110␦ is expressed in many cancers, including colon and bladder carcinoma, glioblastoma, and acute myeloid leukemia blasts. 9,10 In the current study, we demonstrate high expression of p110␦ in patient MM cells. Previous studies have shown that CAL-101, a potent and selective p110␦ inhibitor, has broad antitumor activity against cancer cells of hematologic origin. 11,12 Moreover, inhibition of p110␦ induces cleavage of caspases and LC3, consistent with apoptotic and autophagic cell death, respectively. Here we show that p110␦ blockade with CAL-101, a potent and selective p110␦ inhibitor, inhibits MM cell growth even in the presence of interleukin-6 (IL-6), insulin-like growth factor-1 (IGF-1), or bone marrow stromal cells (BMSCs), associated with decreased phosphorylation of AKT and P70S6k. We also confirmed inhibition of human MM cell growth triggered by p110␦ inhibition in our xenograft mouse models of human MM. These studies therefore show that small molecule inhibitors of p110␦ trigger significant anti-MM cytotoxicity both in vitro and in vivo, providing the framework for their clinical evaluation to improve patient outcome in MM. Methods Materialsp110␦ inhibitor CAL-101 and IC488743 were provided by Calistoga Pharmaceuticals. CAL-101 was dissolved in dimethyl sulphoxide at 10mM and stored at Ϫ20°C for in vitro study. IC488743 was dissolved in 1% carboxyl methylcellulose/0.5% Tween 80 and stored at 4°C for in vivo study. Recombinant human p110␣, ␤, ␥, and ␦ were reconstituted with sterile phosphate-buffered saline (PBS) containing 0.1% bovine serum albumin. Bortezomib was provided by Millennium Pharmaceuticals. 3-Methyladenine was purchased from Sigma-Aldrich. The publication costs of this article were defrayed in part by page charge payment. Therefore, and solely to indicate this fact, this article is hereby marked ''advertisement'' in accordance with 18 USC section 1734. Cell culture Dex 1460BLOOD, 2 SEPTEMBER 2010 ⅐ VOLUME 116, NUMBER 9For personal use only. on March 28, 2019. by guest www.bloodjournal.org From Germany). LB human MM ce...